Mr French suggests that we fail to establish that IV cocaine use is associated with human immunodeficiency virus (HIV) infection. We strongly disagree. The association of HIV infection with cocaine injection was strong in our data and persisted in numerous analyses. We examined literally hundreds of multivariate models to establish that the effect of cocaine injection could not somehow be "explained away." We presented the model in Table 1 of our original article because it was simple and showed all subgroups who had elevated HIV seroprevalence. Each of the variables in the model defines a subgroup with higher-than-expected HIV seroprevalence after controlling for other variables in the model. The fact that some of the subgroups are defined as possessing two characteristics (eg, being nonwhite and injecting cocaine daily) does not seem to us to lead to any ambiguity. As noted in the article, models that include other variables
Chaisson RE, Bacchetti P, Osmond D, Moss AR. Intravenous Cocaine and HIV Infection-Reply. JAMA. 1989;262(11):1471–1472. doi:10.1001/jama.1989.03430110061023
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